Efficacy Of Sorafenib In The Treatment Of FLT3-ITD Positive Acute Myeloid Leukemia:a Meta-analysis

ObjectiveTo evaluate the efficacy of sorafenib in the treatment of FLT3-ITD positive acute myeloid leukemia by Meta-analysis,and provide theoretical basis for its clinical application.MethodsClinical studies about sorafenib in the treatment of acute myeloid leukemia were collected by searching The Cochrane Library,Pubmed,CNKI,VIP Database and Wanfang Database from the building time to December 31,2019.The Jadad scale was used to evaluate the literature quality of the randomized controlled trials,and the Newcastle-Ottawa scale was used to evaluate the literature quality of the retrospective studies.Two researchers independently performed literature screening,inclusion,data extraction,and literature quality evaluation based on the inclusion and exclusion criteria.A fixed or random-effects model of meta-analysis was used depending upon the between-study heterogeneity.The main evaluated indicators include the complete remission rate(CR),CR with incomplete hematologic recovery rate(CRi),cumulative incidence of relapse(CIR),early death rate(EDR),overall survival(OS),progression-free survival(PFS).The Meta-analysis were performed by the software Stata12.0.ResultsTen studies involving 1344 patients were enrolled in our study,which were divided into two groups:the sorafenib group contains 601 patients and the control group contains 743 patients.The meta-analysis results suggested that significant differences were noted in the CR+CRirate(RR=1.717,95%CI:1.024-1.339,P=0.021)and the cumulative incidence of relapse(RR=0.699,95%CI:0.491-0.996,P=0.047)between the patients treated with or without sorafenib.However,there was no significant differences in the complete remission rate(RR=1.045,95%CI:0.899-1.214,P=0.566)and early death rate(RR=0.967,95%CI:0.216-4.324,P=0.965).The results of the meta-analysis also showed statistical difference in the overall survival(HR=0.701,95%CI:0.503-0.976,P=0.036)and progression-free survival(HR=0.370,95%CI:0.209-0.657,P=0.001)of the sorafenib group and the control group.Conclusions1.Sorafenib can significantly improve the CR+CRi rate in patients with FLT3-ITD positive acute myeloid leukemia,and sorafenib does not increase the early death rate of patients compared with the control group.2.Sorafenib can significantly prolong the overall survival and progression-free survival in patients with FLT3-ITD positive acute myeloid leukemia.3.Sorafenib can reduce the cumulative incidence of relapse in patients with FLT3-ITD positive acute myeloid leukemia.